The present study examined effects of an Acceptance and Commitment Therapy (ACT) treatment program for a woman in her forties with chronic low back pain. The treatment program was delivered in 10 sessions. An AB design with a baseline and treatment phase was used to assess effects of the program on an activity based on the participant’s values and health-related quality of life (QOL). The results showed an increase in the activity based on her values. In addition, her Short Form Health Survey (SF-36) scores increased from pre- to post-treatment, especially those on general health perception, vitality, role functioning/emotional, and mental health (RCI＝3.23, 4.84, 2.08, 2.12). Her score on physical functioning also increased from pre-treatment to the 4-month follow-up (RCI＝2.89). Furthermore, the participant’s Roland–Morris Disability Questionnaire scores decreased (RCI＝2.97). Additionally, pain catastrophizing, anxiety, depression, and the process measures of Acceptance and Commitment Therapy significantly improved; these improvements were maintained at the 4-month follow-up. These results suggest that the Acceptance and Commitment Therapy treatment program may have helped this participant who had chronic low back pain by weakening the influence on her behavior exerted by her thoughts or feelings associated with pain and by improving her functional performance.

The present case report describes a male university student’s struggles with procrastination. Psycho-educational training based on Acceptance and Commitment Training (ACTraining) was provided to the student. To evaluate the outcome of the ACTraining, the student self-recorded the tasks that he was procrastinating about and completed 3 self-administered questionnaires: the General Procrastination Scale (GPS), the Acceptance and Action Questionnaire-II (AAQ-II), and the Five Facet Mindfulness Questionnaire (FFMQ). ACTraining was conducted in 4 steps: (a) analysis of the function of procrastination, (b) the student’s learning experimental avoidance, (c) introduction of mindfulness and defusion exercises, and (d) exploration of the student’s values and promotion of valued actions. After finishing ACTraining, the student performed the tasks that he had previously procrastinated about. The scores on the questionnaires changed as follows: GPS (pre: 55, post: 39, −6 points), AAQ-II (pre: 29, post: 24, −5 points), FFMQ (pre: 127, post: 156, ＋27 points). These results were considered from the perspective of relational frame theory. They suggest that ACTraining may be useful for students struggling with procrastination. The possibilities of providing ACTraining for first-year student education and careers education were also discussed.

The present article reports a case study of the use of Acceptance and Commitment Therapy (ACT) with a 32-year-old man with depressive mood. ACT encourages clients to engage mindfully in present behavior and accept worrying about the past and the future. However, when the present client encountered stressors, his depressive mood became exacerbated. Therefore, interventions were initiated, including medication for suicidal ideation. In addition, creative hopelessness was repeated, and work on values conducted. After that, the client increased his repertoire of actions, including a job search, and his symptoms were alleviated. The discussion deals with the requirements involved in applying ACT in medical settings.

The present case study explored the use of Acceptance and Commitment Therapy (ACT) to prevent relapse and recurrence of depression in a client in his late forties who had had chronic kidney disease from his youth. The case formulation indicated that the client had a lack of values clarity, experiential avoidance, and cognitive fusion. His high motivation for Acceptance and Commitment Therapy reinforced the pliance that was a rule-governed behavior in the relationship between the therapist and the client. A self-help book about Acceptance and Commitment Therapy was used as the basis for a discussion about not only the contents of the book, but also events in his daily life. Even though his medical condition became worse and his circumstances drastically changed during the counseling period, the client did not show emotional disturbance, and he reported positive changes in his relationship. Throughout the intervention, his Acceptance and Action Questionnaire-II (AAQ-II) scores increased, his Beck Depression Inventory-II (BDI-II) scores stayed low, and his State-Trait Anxiety Inventory (STAI) scores decreased. The article discusses the process of this case-study intervention from the viewpoint of Acceptance and Commitment Therapy theory.

The present article reports the development of educational software that, from a behavioral analysis perspective, explains the theory and methods of care, and provides experience through a simulation, and which can be operated on a computer. Care staff members (N＝3) conducted self-learning and self-reviewing using this software. Effects of the software on the participants’ ability to move patients from a bed to a wheelchair in a long-term care health facility were evaluated using single case experimental design. All 3 participants improved an average of 46％ in their care ability, and became able to move patients from their beds to wheelchairs with less effort than they had previously used. Additionally, observations suggested that effects of the bed-to-chair moving training were reflected in the undressing care that the participants provided to the patients. The purpose and contents of the training program received relatively good appraisals. This new educational material may complement negative aspects of conventional teaching methods, and may possibly be an effective method of training care staff. However, some issues persist, such as selection of participants, follow-up issues, ease of operation, and the content of the training.

The aim of the present experiment was to examine effects of presenting self-chosen or alternative responses when a decrease in response variability was expected. The participants, 118 undergraduate students, were randomly assigned to one of the following 6 groups: Group S, which was presented with their self-chosen responses; Group E, which was presented only with responses that they had not chosen; Group A, who could choose from all the responses presented; Group O, which was presented with 1 alternative that they had not chosen, in addition to their self-chosen responses; Group N, who were not given an opportunity to choose a response; and a control group. Participants in all groups except the control group played 3 games designed to decrease response variability. Then, a final game that required high response variability was played by all the groups. The results showed that response variability in the final game of Groups S, E, and A was not significantly different from that of the control group, whereas the response variability of Groups O and N was significantly less than that of the control group. These findings suggest that patients in clinical settings may be able to maintain their behavioral variability if their self-chosen responses are clearly distinguishable from responses that they had not chosen.

The present research examined effects of cognitive-behavioral intervention for body dissatisfaction in young women. In Study 1, the cognitive-behavioral intervention group practiced compassionate thinking focusing on appearance-related beliefs. The results in the cognitive-behavioral intervention group were compared to those in an active-listening group that talked about one’s physical appearance without focusing on appearance-related beliefs and a control group that did not engage in either task. The results showed the greatest alleviation of state body dissatisfaction in the cognitive-behavioral intervention group. Study 2 developed a 4-week intervention program including homework for the cognitive-behavioral intervention group, in order to apply the findings of Study 1 to an actual counseling setting. The results demonstrated that the cognitive-behavioral intervention group tended to show a greater decrease in avoidance of social situations and a larger increase in subjective well-being than did the active-listening and control groups.

The present study examined differences between therapeutic effects of safety behavior utilization before and after the peak of fear during exposure to a perceived threat. Undergraduate students (N＝30) with a fear of cockroaches were assigned to one of three conditions: (a) exposure only, (b) safety behavior utilization before the peak of fear resulting from exposure, and (c) safety behavior utilization after the peak of fear. A series of 3 (condition)×3 (measurement period: pre-treatment, post-treatment, one-month follow-up) mixed ANOVAs for scores on measures of fear of cockroaches revealed a significant main effect of time for all measures, indicating improvement at post-treatment and follow-up for all conditions. Based on the change in scores of fear during exposure in each condition, the therapeutic effects of safety behavior utilization before and after the peak of fear were discussed.

The present study developed and psychometrically tested a Japanese version of the Reward Probability Index (RPI). Participants were 392 undergraduate students (199 men, 191 women, 2 unknown; average age＝19.61). Exploratory factor analysis indicated that the Japanese version of the Reward Probability Index consisted of 19 items (1 fewer than the original scale) across 3 factors: “Amount of Reward”, “Environmental Suppressors”, and “Reward Skill”. This scale had internal consistency (Cronbach’s α＝0.86) and 2-week test-retest reliability (interclass correlation coefficient＝0.88). In hypothesis testing, scores on the Japanese version of the Reward Probability Index correlated with the Japanese versions of the Behavioral Activation for Depression Scale–Short Form (r＝0.74, p＜0.01), Environmental Reward Observation Scale (r＝0.75, p＜0.01), Beck Depression Inventory–Second Edition (r＝−0.68, p＜0.01), and Center for Epidemiologic Studies Depression Scale (r＝−0.67, p＜0.01) as expected, indicating construct validity. These results provide evidence that the Japanese version of the Reward Probability Index is an appropriate measure of reward observation.

Recently, treatment based on functional analysis for youth who refuse to go to school has been gathering attention. Kearney (e.g., 2002) and co-researchers classified school refusal behavior into 4 functions, and recommended that treatment of the behavior of youth who refuse to go to school be based on this classification. The present paper reports treatment of 2 school refusers (a female high school student and a male middle-school student) who had common functions: avoidance of school-related stimuli that provoke negative affectivity and escape from aversive social and/or evaluative situations. The therapy for both students included exposure to school-based stimuli and social skills training, and, only for the girl, cognitive techniques. After the treatment, both students’ anxiety about school was reduced, and they were able to go to school. The discussion compares the two youths’ behavior in relation to usefulness of exposure and social skills training for treating students who refuse to go to school whose behavior has these functions, and also deals with how therapists choose and apply techniques based on characteristics of the behavior of the individuals involved.

The present article reports a case study of a woman in her early forties, living alone, who had a major depressive episode in a bipolar II disorder. She became unable to go to work or shop and lost her appetite, and was voluntarily hospitalized. After about a month in the hospital, she spent all her time lying in bed. After that, behavioral activation was initiated, in addition to medication. Based on a functional analysis, activities leading to enjoyment, pleasure, and a sense of achievement, as well as activities leading to reinstatement were gradually increased. Following that intervention, her major depressive episode remitted, and she could return to work. Behavioral activation is a behavior therapy technique that aims to improve depression through changing behavioral patterns. Few studies have been conducted on psychotherapy using this intervention technique with patients with bipolar disorders. The present case study suggests that behavioral activation might be effective for major depressive episodes in bipolar disorders, particularly for patients aiming to return to work.